慢性肾脏病不同分期血钾变化及影响因素分析  

Cross-Sectional Study of Serum Potassium Level in Patients with Chronic Kidney Disease

作　　者：刘迅[1,2] 吕凛生[3] 唐骅[1] 彭晖[1] 石成钢[1] 陈珠江[1] 娄探奇[1] 

机构地区：[1]中山大学附属第三医院肾内科,广东省广州市510630 [2]华南理工大学生物工程学院,广州市510640 [3]中山大学附属第三医院手术室,广州市510630

出　　处：《中华全科医学》2010年第7期817-818,共2页Chinese Journal of General Practice

基　　金：中国博士后基金项目(20090460774);广东省医学科研基金项目(A2009196)

摘　　要：目的调查单中心肾内科门诊慢性肾脏病(CKD)患者血钾水平的基础状况。方法对中山大学附属第三医院肾内科门诊就诊的慢性肾脏病患者进行为期9个月的横断面调查。结果共有718例CKD病例入选。前4位慢性肾脏病的病因分别为原发性肾小球疾病、高血压肾病、狼疮肾炎和糖尿病肾病。随着CKD分期的进展,血钾水平逐期显著性上升。CKD4期以后高钾血症的发生率显著增高。在此同时,CKD各期均有6.6%～11.2%患者发生低钾血症。多元回归分析结果显示,血钾水平和肾小球滤过率、二氧化碳结合力水平、接受保钾利尿剂治疗以及女性呈统计学意义的负相关。结论本研究是目前针对中国CKD患者血钾水平最大规模的单中心横断面调查,它将有助于确定CKD患者血钾水平的变化规律,为进一步综合防治慢性肾脏病及其并发症奠定基础。Objective To present the baseline characteristics of serum potassium level in patients with chronic kidney disease.Methods A cross-sectional study was carried out.Results 713 patients were enrolled in a period of 9 months.The top four cause of CKD in these patients were primary glomerular disease,essential hypertension,lupus nephritis and diabetic nephropathy.Higher level of serum potassium was associated with the stage of CKD stage by stage.Significantly higher incidence of hyperkalemia was associated with 4-5 stage of CKD.In each stage of CKD,6.6%-11.2% patients were associated with hypokalemia.A significantly negative correlation of serum potassium level was found with the level of glomerular filtration rate,carbon dioxide combining power,treatment of potassium-sparing diuretics and female.Conclusion This was the largest cross-sectional study of serum potassium level in patients with chronic kidney disease.It will help to determine the dynamic change of serum potassium level in Chinese CKD patients.

关 键 词：慢性肾脏病 血钾 肾小球滤过率 横断面研究 

分 类 号：R692[医药卫生—泌尿科学] R446.112.1[医药卫生—外科学]